Community participation in health development in Nyandarua District, Kenya
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Date
2003
Authors
Muriithi, Jackson Githinji
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Although community participation in health development exists III Kenya, Community
perceptions and attitude towards its role in health development is unexplored. Similarly the
effect of community participation on health development on health care provision is
undermined and the waiver system meant to promote community participation in health
development in the health care provision remains unevaluated. Hence, this study attempted
to establish the existence of needs assessment, organization, leadership and resource
mobilization as factors that influence community participation in health development in
rural community setup in Nyandarua district. Both structured interviews and focus group
discussion were used to collect data from Community Respondents, Rural Health Facility
Staff and the Rural Health Facility Management Committees.
In terms of knowledge, significant differences (X2 = 46.94972; P = 0.00007) on the role of
community respondents in health development were found between rural health facility staff
and community respondents. There were also significant differences in knowledge between
age groups (X2 = 28.49994; P = 0.00150) but marital status and gender were insignificant.
Significant differences were also noted in knowledge between those who attended barazas
(X2 = 16.31502; p= 0.00029) and those who did not and also between those who accessed
waivers and those who did not (X2 = 28.21035; P = 0.00001). Only 5.7% of the community
respondents had good perception on their role in health care provision. There were
significant differences (X2 = 14.10904; P = 0.00086) in perception between gender as well as
baraza attendees and non-attendants (X2 = 109.69402; P = 0.0000). Almost all the Rural
Health Facility Staff 94.7% had good knowledge of health care provision compared to only
5.3% who had fair knowledge. Majority of Rural Health Facility Staff interviewed 76.3%
had fair perception of health care provision. Significant differences in leadership were noted
between gender (X: = 9.87759; p = 0.00716), waivers (X2 = 33.45095; p = 0.0000) and
education levels (X2 = 12.9204; p = 0.04432) of the community respondents. Further,
significant differences (X2 = 14.38694; P = 0.00075) were found in organization between
gender, baraza attendance (X2 = 35.56165; P = 0.0000) and waivers (X2 = 59.84615; P =
0.0000). There was a significant difference in resource mobilization between marital status
(X2 = 6.62548; p = 0.03642) and those who accessed health service without payment (X2 =
32.59359; p = 0.0000).
The overall level of community participation was fair (score 7.8) and the order of the
indicator factors was leadership (score 2.2), organization (score 2.0) resource mobilization
(score l.9) and needs assessment (score l.8). Since the community had gradually been
involved in the work of the rural health facilities, the government should give the Rural
Health Facility Management Committees legal status from which specific obligations and
regulations should be laid down. In this way the community will be given the responsibility
to increase their contribution to the financ ng of promotional, preventive and curative health
care activities. Community participation takes place through the RHFMC, which are loosely
established, in the public health organizational structures.
Description
Department of Community Health, 111p. 2003, HN 49.C6M8